BLOOD VESSEL PATHOLOGY Flashcards
most imp risk factor for DVT
prolonged immobilization
Primary or secondary Raynaud?
- exaggerated central and local vasomotor responses to cold or emotion
- Young women
- symmetrically affect the extremities
- Static extent & severity
Primary Raynaud phneomenon
1. Identify the lesion described:
a. calcification of the walls of muscular arteries, typically involving the internal elastic membrane
b. do not encroach on the vessel lumen
c. not clinically significant.
2. Radiographic pattern?
- Mönckeberg medial calcific sclerosis
- Pipestem appearance
homogeneous, pink hyaline thickening with associated luminal narrowing
Hyaline arteriolosclerosis
•Necrotizing granulomas of URT/LRT & Kidneys +Necrotizing granulomatous vasculitis of small/medium vessels esp lungs & upper airways
- PR3-ANCAs -up to 95% of cases
- •sinusitis / mucosal ulcerations of the nasopharynx
- bilateral nodular and cavitary infiltrates
Wegner granulomatosis (Granulomatosis with Polyangiitis)
Identify the vasculitis:
- •Main arteries affected- temporal, vertebral, ophthalmic
- Age >50
- Microscopy: medial granulomatous inflammation centered on the internal elastic lamina
- •Increased ESR , sometimes exceeding 100mm/1st hour
- Assoc with polymyalgia rheumatica
Giant Cell (Temporal) Arteritis
Most common cause of thoracic aortic aneurysms
Hypertension
Identify the lesion described:
•malignant endothelial neoplasm
- Develops in the ipsilateral upper extremity several years after radical mastectomy
Lymphangiosarcoma
Identify the lesion described:
frequency increases with age, does not regress.
Microscopy shows thin-walled capillaries with scant
stroma
Cherry hemangioma
3 conditions assoc with hyaline arteriolosclerosis
- hypertension
- diabetic microangiopathy
- Nephrosclerosis
Identify the lesion described:
assoc with Turner Syndrome
Indistinct margins, unencapsulated
massively dilated lymphatic spaces lined by endothelial cells and separated by intervening connective tissue stroma containing lymphoid aggregates.
Cystic Hygroma (Cavernous Lymphangioma)
•conjunctival and oral erythema
- •desquamative rash of palms and soles
- Coronary artery aneurysm
- Strawberry Tongue
- Hand and feet edema
- less than 4 years old
Kawasaki Disease (MUCO CUTANEOUS LYMPH NODE SYNDROME)
Is this a Vulnerable/ Stable plaque?
- Thin fibrous cap
- Large lipid core
- Intense inflammation
Vulnerable
Identify this condition:
Assoc with hyperestrogenic states
radial,pulsatile arrays of dilated subcutaneous arteries/arterioles bout a central core
blanch with pressure
Spider telangiectasia
Why do we get onion skinning in malignant hypertension- what do those laminations represent?
Laminations consist of smooth muscle cells with thickened, reduplicated basement membrane
What is the downstream effect of fibromuscular dysplasia?
Can cause renal artery stenosis which in turn leads to secondary hypertension
In a hypertensive with activation of the RAA axis, where will the levels of Angiotensin II be highest?
Pulmonary artery or pulmonary veins?
Pulmonary veins - as ACE is produced primarily within the endothelial cells of small pulmonary vessels
Identify the lesion described:
- malignant endothelial neoplasm
- older adults
Assoc with exposure to Thorotrast/arsenic/polyvinyl chloride
plump, atypical endothelial cells forming vascular channels
Hepatic angiosarcoma
Identify this lesion:
assoc with von Hippel Lindau disease
large, cavernous blood-filled vascular spaces separated by connective tissue stroma
Cavernous hemangioma
small-vessel
MPO-ANCAs
Classically associated with asthma, allergic rhinitis, lung infiltrates, peripheral hypereosinophilia
Multisystem involvement
extravascular necrotizing granulomas
Churg - Strauss Syndrome aka allergic granulomatosis and angiitis
- What is the gross appearance called?
- Secondary to which infection?
- Which layer of the vessel is affected?
- Tree barking
- Syphilis
- Vasa Vasorum
- Identify the lesion described below:
Young woman of child bearing age
Histopathologic examination of the renal arteries exhibit collagenized tunica media alternating with regions of thinned media
Angiogram image attached
- What’s the classic pattern seen on angiogram called?
- Fibromuscular dysplasia
- Beading